Investigation Of The Respiratory Drive Efficacy Of Patients With Chronic Obstructive Pulmonary Disease

Objective Chronic obstructive pulmonary disease(COPD)is a kind of restricted airflow characteristics of preventable and treatable diseases.Airflow limitation is not fully reversible,with the gradually development.It is the body's abnormal inflammatory responses to cigarette smoke,and other gases or particles harmful, Mainly involving the lungs,But it can also cause systemic(or extrapulmonary) adverse effect.The disease is of slow progress,and patients are gradually lead to decreased exercise capacity until respiratory failure,which not only affects the lives of the people,but also give a heavy financial burden on families with the disease.Many reasons can cause respiratory failure,Respiratory regulation of any abnormal areas may lead to respiratory failure occurred,as one of the core areas,the respiratory center is a more important role.For the central respiratory drive of the target in a longer period of time has experienced the development,We compare the current consensus is that we can take 0.1 seconds after the start of the inspiratory oral blocking pressure(P0.1)as a measure of the size of the central respiratory drive indicators.But the central respiratory drive COPD patients trend study is divided. Most of the experts and scholars think that the central respiratory drive capacity in COPD patients is relatively normal and enhanced,but there are a small part of scholars hold different views;And about the strength of the central respiratory drive influencing factors in patients with COPD,experts and scholars have also done a lot of work.At present,they think that patients with COPD central respiratory drive is related to the changes in PaO2,Sa02 and so on.In addition,sleep is a special Physiological time.It is more agreeable to everyone:central respiratory drive is different degrees of weakening in sleep than in awake.For COPD patients in the acute stage of the central respiratory drive efficacy changes in trends,the application of non-invasive mechanical ventilation in the treatment of COPD patients before and after the changes in the central respiratory drive efficacy,and the differences of central respiratory drive between Sober and sleep,there are lack of relevant researches.To investigate COPD patients in the acute stage in the central respiratory drive,application of non-invasive mechanical ventilation in patients with COPD around the central respiratory drive the trend of changes in COPD patients with sleep sober central respiratory drive,as well as the similarities and differences in the strength of the central respiratory drive,and other relevant factors,we conducted the study.Methods:1.Group of not using of non-invasive mechanical ventilation.We select 48 cases(male 25,female 23 cases)of hospitalized COPD patients with respiratory failure from August 06,2007 to May 07,2007,the average age of 65.03±8.25 years. Respectively,test the central respiratory drive in patients with COPD in acute stage and remission,sober and sleep,as well as blood analysis in acute stage and remission period in the daytime,and respectively analysis the correlation of changes of central respiratory drive and changes in blood oxygen and carbon dioxide partial pressure.2. Group of application of non-invasive mechanical ventilation We select 40 cases(male 22,female 18 cases)of hospitalized COPD patients with respiratory failure from August 06,2007to May 07,2007,the average age of 67.5±7.5 years.Respectively, test the central respiratory drive in patients with COPD in acute stage and remission,sober and sleep,as well as blood analysis in acute stage and remission period in the daytime;Records of the time required to ease the condition is compared to that of the group of application of non-invasive mechanical ventilation.Results:1 Among patients not using non-invasive mechanical ventilation,the central respiratory drive as follows:in the acute stage sober at 0.446±0.002Kpa,sleep at 0.315±0.001 Kpa,P0.1/PIMAX 0.078±0.001;remission sober at 0.338±0.001 Kpa,sleep at 0.219±0.001 Kpa,P0.1/PIMAX 0.058±0.001.The central respiratory drive is higher in acute phase of COPD than that of remission period,a statistically significant difference(P＜0.05).Correlation analysis suggested that P0.1(sober)and PaO2 changes in value before and after treatment was significantly negative correlation(r=-0.984,p＜0.01),P0.1(sober)and PaCO2 before and after treatment was significantly changes the value of being related(r=0.987,p＜0.01),mitigation time is 18±3天.2 Among patients applying non-invasive mechanical ventilation,the central respiratory drive as follows:in the acute stage sober at 0.446±0.008 Kpa,sleep at 0.320±0.06 Kpa;remission awake at 0.325±0.105 Kpa,sleep at 0.206±0.09 Kpa. the central respiratory drive is higher in acute phase than that of remission period,a statistically significant difference(P＜0.05);mitigation time is13±2天,differences between two groups are statistically significant(P＜0.05).Conclusion:whether in the state of sober or the state of sleep,in the patients with COPD,the central respiratory drive in the acute stage is higher than in remission.Central respiratory drive have a certain relationship with the level of hypoxia and hypercapnia.The central respiratory drive decrease to a certain extent in sleep.In the patients with COPD,non-invasive mechanical ventilation might improve the central respiratory drive,Shorten the time of mitigation.